Shortlisting system solutions

The Clinical Working Groups (CWGs) met a number of times to discuss all viable configuration options for their service area and undertook an indicative scoring exercise against the STP’s evaluation criteria. This scoring exercise enabled the CWGs to develop a long list of options viable for further analysis.

The Clinical Advisory Group (CAG) considered the long list of configuration options from each CWG in order to identify interdependencies that would require further analysis and consideration at a CWG level. The CWGs then re-scored each configuration option. The difference with the previous scoring exercise was that further analysis was available to support the scoring exercise and the CWG scored the options against the evaluation sub-criteria.

The outcome of the CWG scoring exercises was reviewed by the CAG. The CAG then considered combinations of viable configuration options, taking into account interdependencies between the proposals from individual working groups, and recommended a preferred configuration of services to the Health and Care Executive.

Design principles

In developing the vision for sustainable care the CWGs took into account the following design principles.

PrincipleDefinition
High quality care• Solutions should deliver safe, effective care for all when needed.
• Services should provide a positive experience for patients and carers.
Integrated care• Services should be delivered through joined-up health and social care that treats the ‘whole person’ and delivers a seamless service with minimal duplication of processes.
• This will require joined-up working across different groups of care givers from the different health and care organisations, as well as full involvement of patients, carers and, where appropriate, the voluntary sector.
Right care, right time, right place, right people• Solutions should enable patients to receive health and social care appropriate to their particular needs.
• This means providing proactive, timely care that takes into account patients’ particular circumstances.
• Care should be provided in the most appropriate place. Where possible care should be provided locally (close to home and/or in the community).
• Some more specialised services may need to be centralised in order to provide safe services, with safe staffing levels.
• Care should be provided by the most appropriate care giver.
Minimise inequality• Services should be designed to improve the health outcomes for all and minimise health inequalities.
• Solutions should not have a disproportionately adverse impact on any specific patient groups.
Maximising value for the public• Solutions should deliver efficient and cost effective care, by reducing the system-wide costs to deliver services.
• Solutions should make the best use of existing buildings and equipment, where possible.

 Evaluation criteria

The Clinical Advisory Group (CAG) and Health and Care Executive agreed a set of evaluation criteria to assess the configuration options. The evaluation criteria and sub-criteria were weighted, taking into account the views of the CAG, Finance Directors Forum, and Cambridgeshire and Peterborough’s Healthwatch organisations.

Evaluation Criteria
Quality
Alignment to national best practice guidelines including clinical standards
Impact on patient safety and population health outcomes
Impact on patient experience
Impact on health inequalities
Impact on patients’ ability to access services (journey times)
Affordability
Options deliver a sustainable income and expenditure position
Transition costs including capital expenditure
Sustainability
Ability to recruit and retain sufficient staff with appropriate skills and expertise
Extent to which the model meets future demand for service provision
Deliverability
Stakeholder support
Ease and speed of implementation
Alignment to local and/or national policies or strategies